Carpal bone cysts: MRI, gross pathology, and histology correlation in cadavers

Cyst formation in the subchondral bone following cartilage repair

Subchondral bone cysts represent an early postoperative sign associated with many articular cartilage repair procedures. They may be defined as an abnormal cavity within the subchondral bone in close proximity of a treated cartilage defect with a possible communication to the joint cavity in the absence of osteoarthritis. Two synergistic mechanisms of subchondral cyst formation, the theory of internal upregulation of local proinflammatory factors, and the external hydraulic theory, are proposed to explain their occurrence. This review describes subchondral bone cysts in the context of articular cartilage repair to improve investigations of these pathological changes. It summarizes their epidemiology in both preclinical and clinical settings with a focus on individual cartilage repair procedures, examines an algorithm for subchondral bone analysis, elaborates on the underlying mechanism of subchondral cyst formation, and condenses the clinical implications and perspectives on subchondral bone cyst formation in cartilage repair.

Scaphoid Cysts: Literature Review of Etiology, Treatment, and Prognosis

Background: Cystic lesions of the carpal bones are rare entities that are infrequently reported in the literature. Scaphoid intraosseous cystic lesions represent a rare subset of carpal bone cysts. This review aims to summarize the available evidence on the evaluation and treatment of scaphoid cystic lesions to help guide clinical management. Methods: Systematic electronic searches were performed using PubMed, Ovid, and Embase databases. Studies included were graded for their risk of bias. Pooled descriptive statistics were performed on incidence, etiology, physical exam findings, treatment, and follow-up. Results: A total of 38 patients representing 41 scaphoid cystic lesions were pooled from 27 articles. Patients presented with wrist pain without fracture (n = 27), pathological fracture (n = 9), swelling only (n = 1), or were asymptomatic (n = 4). Cystic lesions of the scaphoid were initially revealed on imaging with radiographs alone (n = 22), radiographs in combination with computed tomography (CT) (n = 10) or magnetic resonance imaging (n = 6), CT alone (n = 1), or using all 3 modalities (n = 2). Intraosseous ganglia were identified most frequently (n = 31), followed by "bone cyst-like pathological change" (n = 3), unicameral bone cysts (n = 2), aneurysmal bone cysts (n = 2), primary hydatid cysts (n = 2), and cystic like changes post fall (n = 1). Treatment modalities included curettage and bone graft (n = 39) or below-elbow cast (n = 2). On follow-up (average of 21.3 months; n = 40), all patients improved clinically after treatment and were found to have full wrist range of motion without pain (n = 31), slightly reduced grip strength (n = 3), limited range of motion (n = 2), or persistent mild discomfort (n = 2). Conclusions: Scaphoid cystic lesions are most commonly intraosseous ganglia, but can include other etiologies as well. The main presenting symptom is radial wrist pain that usually resolves after treatment. The presence of intracarpal cystic lesions should be considered in the differential diagnosis of wrist pain.

Nomenclature of Subchondral Nonneoplastic Bone Lesions

OBJECTIVE. The purpose of this article is to summarize the nomenclature of nonneoplastic conditions affecting subchondral bone through a review of the medical literature and expert opinion of the Society of Skeletal Radiology Subchondral Bone Nomenclature Committee. CONCLUSION. This consensus statement summarizes current understanding of the pathophysiologic characteristics and imaging findings of subchondral nonneoplastic bone lesions and proposes nomenclature to improve effective communication across clinical specialties and help avoid diagnostic errors that could affect patient care.

Unicameral bone cysts: Current concepts

Unicameral bone cysts (UBC) or simple/solitary bone cysts are benign fluid filled cavities that enlarge over time, resulting in thinning of the bone. Usually these cysts are reported in the metaphyseal areas of long bones with open physes. 85% of UBCs occur almost exclusively in children and adolescents. UBCs are more aggressive in the first decade of life and correspondingly the recurrence rate for these patients is four times that for adolescents. The proximal humerus and femur account for almost 90% of these cases. UBCs are classified as active when they are within 1 cm of the physis and latent as they progress to a diaphyseal location. Differential diagnoses for UBC include aneurysmal bone cyst, fibrous dysplasia, enchondroma, and intraosseous ganglia. By the time of skeletal maturity most UBCs tend to resolve. Nonoperative treatment may be a viable option for many patients with small or symptomatic lesions. Interventions include steroid injection, open curettage and bone grafting, decompression and percutaneous injection of marrow or graft substitutes.

A Comprehensive Review of Medical Imaging Equipment Used in Cadaveric Studies

Medical imaging techniques have led to great advances in clinical anatomy and forensic pathology. New and emerging technologies allow healthcare professionals to view and understand the human body from different perspectives. This gives way to new and improved interventions, treatment plans, and an overall understanding of the human body. Herein, we present a comprehensive review of the various medical imaging equipment used in cadaveric studies along with their individual strengths and limitations.